In the field of respiratory care, an endotracheal tube may be placed directly into the trachea, or airway, for ventilation via a life support system. Currently there are a number of ways and products on the market for stabilizing an endotracheal tube. The problems of stabilizing an endotracheal tube with the use of tape have been well-documented in the past. In the field of respiratory care, when patients are being ventilated through a mechanical ventilator, warm, humidified gasses are used to prevent the airway from drying, and to prevent the body from giving up moisture in order to humidify this gas. Consequently, these gasses also warm the endotracheal tube, which reduces the adhesiveness and securing ability of tape. This increases the possibility of inadvertent extubation and dislodgement of the tube, a potentially life-threatening situation. Not only does the heat and humidity decrease the adhesiveness, but this, in concert with oral secretions, greatly increases the chances of inadvertent dislodgement occurring.
In light of today's hospital environment and the advent of HIV in patient blood and secretions, the ideal endotracheal tube stabilizing device is one that reduces the amount of exposure time involved in stabilizing the tube. It is common practice for respiratory care practitioners to wear latex protective gloves to prevent the spread of hospital-acquired infection, but the use of gloves has proven difficult as the gloves stick to the tape. The ideal endotracheal tube stabilizing device therefore would be easy to install and remove while wearing gloves, would reduce unnecessary exposure to the clinician, and would prevent nosocomial infection.
Specific to the trauma setting, patients often come into the hospital with head injury, facial trauma and profuse bleeding. In these cases, stabilizing the tube can be nearly impossible because the blood fully saturates the tape as it is being applied around the face and endotracheal tube. Also, every trauma patient who has a suspected neck injury, arrives at the hospital wearing a cervical collar to prevent further injury. In the event of a decrease in the patient's neurological status, the physician will electively decide to intubate the patient as a safety precaution as a C.T. scan is performed to rule out bleeding within the brain cavity. The endotracheal tube is thus secured using tape around the cervical collar. If the endotracheal tube is placed too far down into the trachea, the tube will have to be retracted for proper ventilation, and the entire process of securing the tube repeated. After an X-ray examination, if the results are negative for injury, and after removal of the X-ray equipment, the cervical collar will be removed, requiring the tape to be removed, and the entire stabilization process repeated to adequately secure the tube.
The ideal endotracheal tube stabilizing device would be for single-patient use, disposable, packaged clean, contain low manufacturing costs, and would be a charged item for the hospital.
As mentioned previously, there are a number of medical devices on the market today for stabilization of the endotracheal tube. Most encompass some type of a glue to secure the tube. While in most instances the outward appearance of these look sturdy, it is not until the patient is turned from side to side or lifted for morning X-ray does the tube become dislodged.